Lichen planus: Symptoms Causes and Treatment

• Lichen planus is a rare papulosquamous skin condition. It affects people of all ages, but it is most common between the ages of 30 and 60. 

• Children and newborns are rarely impacted. 

• There are no racial or gender inequalities.

• Lichen planus is caused by an immunological malfunction of cytotoxic T-cell response.

• It has been hypothesized that hereditary susceptibility exists. 

• The skin rash has been linked to systemic medications and the hepatitis C virus, but no clear cause has been discovered. 

• Gold, antibiotics, diuretics, and antimalarials are common medicines associated with lichen planus.

Lichen Planus Symptoms

• Patients frequently complain of itching and the appearance of red pimples. The severity of the pruritus can range from moderate to severe, with some patients experiencing no symptoms at all.

• When lichen planus affects the mouth, it can cause symptoms such as burning or stinging when exposed to hot or spicy foods.

• Lichen planus initial lesions are violaceous flat-topped and firm papules. 

• These might be scaly in texture and spherical or polygonal in form. Lesions are often seen symmetrically on the flexor wrists, forearms, ankles, lower back, and genitals.

• Mucous membrane lichen planus is common and manifests as a net-like white stripe on the buccal mucosa (Wickham striae).

• Oral ulceration is possible. 

• Scalp lesions with scarring alopecia might be the only symptom of the condition. 

• The capacity of lichen planus to Koebnerize is a distinguishing characteristic. Trauma causes this occurrence, with lichen planus appearing in the region of damage. 

• Hypertrophic types (hypertrophic lichen planus) that are both widespread and localized can develop. The anterior shins are the most commonly affected by hypertrophic lichen planus, and the papulonodules have significant hyperkeratosis. 

Biopsy

• A skin biopsy is the most helpful diagnostic test. The biopsy reveals a homogeneous band-like lymphocytic infiltration at the epidermis's base. 

• In some cases, the histologic result may indicate drug-induced lichen planus.

Lichen Planus Treatment

• If an offending agent is detected, the first step is to remove it. Common disorders that may appear with a lichenoid skin eruption include drug-induced lichen planus and hepatitis C.

• Lichen planus can be treated with medium-potencycorticosteroids administered 1 to 3 times daily to the afflicted region. 

• When the eruption is under control, the need for drugs can be minimized or removed.

• When using corticosteroids for an extended length of time, care must be taken to avoid drug-induced secondary alterations such as atrophy.

More information

Lichen Planus Support Group: www.mdjunction.com/lichen-planus

American Academy of Dermatology: www.aad.org/skin-conditions/dermatology